Role Of Laboratory Research Articles

The Key Role of Pulsed-Field Gel Electrophoresis in Investigation of a Large Multiserotype and Multistate Food-Borne Outbreak of Salmonella Infections Centered in Pennsylvania

Five different serotypes of Salmonella enterica were implicated in a large outbreak linked to fresh Roma tomatoes served at gas station deli counters in Pennsylvania and nearby states during July 2004: S. enterica serotypes Javiana, Anatum, Thompson, Typhimurium, and Muenchen. One of these serotypes, Anatum, was isolated from both tomatoes and patients. Pulsed-field gel electrophoresis (PFGE) played a key role in identifying the outbreak-associated isolates and distinguishing them from unrelated sporadic isolates. It also demonstrated that the genetic fingerprints of serotype Anatum isolates derived from patients were indistinguishable from those derived from tomatoes. Rapid communication of PFGE fingerprints with other public health laboratories through the Centers for Disease Control and Prevention's PulseNet USA national molecular surveillance network for bacterial food-borne pathogens facilitated the tracking of this outbreak in other states. The work described in this report emphasizes the laboratory's role in core public health functions and services, thereby providing a highly visible example of public health in action.

Biochemistry testing associated with pregnancy and the newborn period—A lot has changed since you were a baby!

Everyone has been a newborn, and everyone's mother has been pregnant. Despite the commonality of these events, medical care and the clinical chemistry laboratory's role in it have changed remarkably over the last 50 years. This review is a historical overview of clinical chemistry testing that is related to pregnancy and the newborn period.

Supporting the Water Quality Laboratory's Role in Ensuring Safe Drinking Water

This article discusses how the AWWA Water Quality Laboratory Committee has provided a forum for the discussion of important issues facing drinking water labs. The committee is part of the Water Quality & Technology Division, which in turn is part of the Technical & Education Council of AWWA. The stated purpose of the committee is to study and report on issues pertinent to water quality laboratory activities and responsibilities. The Water Quality Laboratory Committee is composed of representatives from utility, public health, government, and university laboratories. The approach the Committee takes to encourage discussion of important topics for drinking water labs is discussed in the article, along with the expertise of committee members, committee activities and goals.

Public health decisions: the laboratory's role in the Lorain County, Ohio, investigation.

In 1994 officials from the Ohio Department of Health reported that some residents of Lorain County, Ohio, possibly had been exposed to methyl parathion (MP), a highly toxic restricted-use pesticide. The U.S. Centers for Disease Control and Prevention (CDC) assisted in the investigation by providing epidemiologic and laboratory support to the state and local health departments. Although the initial investigation found MP inside the homes, it was unclear if the residents were exposed. CDC used a new biological monitoring method to measure urinary p-nitrophenol (PNP), the metabolite of MP. This biological monitoring measures the internal dose from exposure to toxic chemicals from all routes. Laboratory analyses demonstrated that the urine of residents contained moderate to high levels of PNP, with median, mean, and highest reported concentrations of 28, 240, and 4,800 g/L, respectively, thus confirming exposure of the residents. Almost 80% of the residents had urinary PNP concentrations above the 95th percentile of the reference range concentrations. This information, combined with other analytical results of air and wipe tests, guided public health officials' decisions about the potential risk in each household. In this article we illustrate the laboratory's role in providing information to assist in making these public health decisions. Furthermore, it illustrates how a multidisciplinary team from various governmental agencies worked together to protect the public's health.

The microbiology laboratory's role in response to bioterrorism.

○ Context.-Bioterrorism has existed since before the 14th century; however, the specter of such an attack is much greater today than ever before. Technical expertise in microbiology and molecular testing, combined with the rapidity of worldwide air travel, has ensured that no geographic area would be untouched in a widespread attack. Clinical microbiology laboratories will play a pivotal role in the detection of attacks involving weapons of mass destruction. Objective.-To identify and discuss the microorganisms most likely to be used as agents of bioterrorism. Data Sources.-Data were obtained from literature searches from 1997 through June 2001 using the subject headings of bioterrorism, biological weapons, biological warfare, anthrax, brucellosis, tularemia, smallpox, plague, and botulism. In addition, information was obtained from publications of the Center for Civilian Studies, Johns Hopkins University, the Centers for Disease Control and Prevention, American Society for Microbiology, and the United States Army Medical Research Institute of Infectious Diseases. Data Extraction and Synthesis.-Findings obtained from these studies and publications were analyzed for the most likely microorganisms that would be involved in a bioterrorist attack and the most efficient means by which they could be identified. In all instances, the guidelines from the Centers for Disease Control and Prevention for Level A laboratories were observed. Conclusions.-The most likely microorganisms to be utilized as biological weapons include Bacillus anthracis (anthrax), Brucella species (brucellosis), Clostridium botulinum (botulism), Francisella tularensis (tularemia), Yersinia pestis (plague), and variola major (smallpox). While knowledge of the potential of these microorganisms is critical, clinical microbiologists and medical technologists possess the basic tools to rule out the suspected pathogens or to refer these isolates to public health laboratories for identification and susceptibility testing.

The microbiology laboratory's role in response to bioterrorism.

Bioterrorism has existed since before the 14th century; however, the specter of such an attack is much greater today than ever before. Technical expertise in microbiology and molecular testing, combined with the rapidity of worldwide air travel, has ensured that no geographic area would be untouched in a widespread attack. Clinical microbiology laboratories will play a pivotal role in the detection of attacks involving weapons of mass destruction. To identify and discuss the microorganisms most likely to be used as agents of bioterrorism. Data were obtained from literature searches from 1997 through June 2001 using the subject headings of bioterrorism, biological weapons, biological warfare, anthrax, brucellosis, tularemia, smallpox, plague, and botulism. In addition, information was obtained from publications of the Center for Civilian Studies, Johns Hopkins University, the Centers for Disease Control and Prevention, American Society for Microbiology, and the United States Army Medical Research Institute of Infectious Diseases. Findings obtained from these studies and publications were analyzed for the most likely microorganisms that would be involved in a bioterrorist attack and the most efficient means by which they could be identified. In all instances, the guidelines from the Centers for Disease Control and Prevention for Level A laboratories were observed. The most likely microorganisms to be utilized as biological weapons include Bacillus anthracis (anthrax), Brucella species (brucellosis), Clostridium botulinum (botulism), Francisella tularensis (tularemia), Yersinia pestis (plague), and variola major (smallpox). While knowledge of the potential of these microorganisms is critical, clinical microbiologists and medical technologists possess the basic tools to rule out the suspected pathogens or to refer these isolates to public health laboratories for identification and susceptibility testing.

Pneumonia in the immunocompromised host: the role of bronchoscopy and newer diagnostic techniques.

The microbiology laboratory plays an essential role in the laboratory diagnosis of pneumonia in the immunocompromised host. Both the diversity of underlying or predisposing host conditions that increase risk for pneumonia and the variety of microbial agents that may be etiologically responsible make the laboratory's role in the diagnostic process a challenging one. In addition, the laboratory has a number of diagnostic tools available for detection of etiologic agents including conventional stains and cultures as well as newer tests relying on antigen detection and molecular techniques. Respiratory specimens available for testing are also diverse and are often obtained by the use of fiberoptic bronchoscopy, but may be complemented by use of blood samples when dissemination is likely or more recently by urinary antigen testing in select cases. Given the large number of variables in the design of a diagnostic approach to pneumonia in the immunocompromised host, it is critical that laboratorians and clinicians cooperate in the development of protocols that are cost effective and appropriate to their specific clinical settings.

Living with multiple standards - QA in a multidisciplinary laboratory

The paper describes the experiences of a medium-sized analytical laboratory in implementing and developing a quality system compliant with several standards. The effect of the laboratory's changing role and work pattern on the quality system are considered. The laboratory costs are explored. The laboratory's particular experiences are shown to be consistent with recent market research in the United Kingdom. Some of the factors a laboratory needs to consider in formulating a quality strategy are described, including the possibility of joint assessments. Also, possible courses of development of the standards themselves are suggested. These developments could simplify the existing situation where laboratories are forced into a quality approach based on multiple standards and assessment.

The Laboratory's Role in Reporting Communicable Diseases

The Laboratory's Role in Reporting Communicable Diseases

The Laboratory's Role in Detecting Sexual Assault

Sexual assault, a crime of violence and control, is prevalent in the United States. Most of the victims are female and the assailants male. The crime usually is unwitnessed and, unfortunately, the majority of the assailants are never prosecuted. The number one reason for lack of prosecution is lack of demonstrative evidence. The most crucial evidence in court is that of the laboratory, used to prove or disprove the presence of semen. As clinical laboratory professionals, we bear great responsibility in the handling and interpretation of this evidence. With the discovery of better staining techniques, chemical analyses, and molecular pathology, we are now able to bring the laboratory into the courtroom and use our knowledge to bring positive proof against the assailant. We are obligated to the victim and the community to properly use this knowledge to document, process, and interpret the evidence to the best of our ability.

The Laboratory's Role in Reducing Hazardous Waste

In Albuquerque, NM, a novel, proactive pollution-prevention plan helps biomedical laboratories reduce the volume of hazardous chemical wastes in the sewer system. Sewer agencies regulate heavy metals, which are commonly used in reagents, cleaning products, fixatives, stains, and elsewhere in the laboratory. Laboratories can keep these wastes to a minimum by using substitutes when possible and handling the wastes carefully.

Hematology Testing at the Bedside

Bedside testing is appropriate for analyses in which rapid answers lead to immediate therapeutic decisions. Bedside testing instruments are designed for use by individuals without technical laboratory training. Hematology systems perform tests such as activated clotting time, spun hematocrit, hemoglobin, prothrombin time, and activated partial thromboplastin time. This article reviews the quality management procedures required by several accrediting and regulatory bodies, including the Clinical Laboratory Improvement Amendments of 1988 and the Joint Commission on Accreditation of Healthcare Organizations. In the future, more of these systems may be placed in hospitals and other patient care settings, and the laboratory's role in managing testing quality will increase. This is the final article in a two-part continuing education series on bedside testing. The first article focused on data management of bedside glucose testing.

Temples of the future: an historical overview of the laboratory's role in public health practice.

Public health practice predates the development of the public health labora­ tory. But, with the birth of modem laboratory science, especially microbiology and serology, disease prevention and control activities developed a more rational scientific basis and, hence, more effective outcomes. However, before the public health laboratory could exist, two prerequisites were necessary: a firm knowledge base that supported laboratory practice as a routine component of scientific inquiry, and a stable and administratively sound organization devoted to public health, into which the laboratory could be integrated. Both elements were lacking in America's early years. Several American cities established boards of health in the late eighteenth and early nineteenth centuries (26); however, these boards tended to be poorly organized and often lay dormant until an epidemic knocked at the gates of the city (25). Urbanization and rapid population growth, both consequences of industri­ alization, created health problems that, unlike epidemics, were not cyclical in nature. The persistently negative health consequences of poor housing, overcrowding, and inadequate sanitation were difficult to ignore and raised public health issues to a level that demanded permanent action. In the years

Temples of the Future: An Historical Overview of the Laboratory's Role in Public Health Practice

Temples of the Future: An Historical Overview of the Laboratory's Role in Public Health Practice

Gallo to tell his side of AIDS virus dispute

This week, National Institutes of Health AIDS researcher Robert C. Gallo will speak openly for the first time about the controversy surrounding his laboratory's role in the 1984 discovery of the AI...

P-glycoproteins in pathology: The multidrug resistance gene family in humans

Many cancers do not respond to chemotherapy on primary exposure to drugs, thus manifesting intrinsic drug resistance. Other cancers that do initially respond subsequently become resistant to the same drugs and simultaneously to other drugs to which the patient has had no previous exposure. This is a form of acquired drug resistance. There is a pressing need to better understand the mechanisms of drug resistance and to use this information to develop strategies for the chemosensitization of drug-resistant tumors. A goal of the pathology laboratory is to offer chemosensitivity tests that identify intrinsic or acquired resistance of tumors to specific drugs or classes of drugs to enable the clinician to tailor therapy to the biology of cancers in individual patients. Multidrug resistance is one type of drug resistance. It can be present in either an intrinsic or acquired form. The human gene that confers human multidrug resistance, the MDR1 gene, has been cloned and classified as a member of the MDR gene family. Its encoded protein, called Mdr1, is an energy-driven membrane efflux transporter that maintains intracellular concentrations of certain chemotherapeutic drugs at nontoxic levels. Useful model systems for studying multidrug resistance have been developed in several research laboratories. Applying selection pressure by exposing cultured cancer cells to escalating doses of natural product anti-cancer drugs allows cross-resistant cell lines to be produced which share patterns of drug resistance with human cancers. A common feature of these drug-resistant lines is the expression of Mdr1. Using techniques of genetic engineering, molecular probes have been developed that can be used to measure MDR1 mRNA and MDR1 gene amplification. Mdr can be measured by immunochemistry methods. Currently, such measurements are being used to stratify patients in clinical trials designed to determine if chemosensitization by inhibition of the pump function of Mdr is a clinically useful therapeutic strategy. If sucessful, Mdr/ MDR1 mRNA laboratory testing might significantly increase the clinical laboratory's role in cancer patient management.

'Ticking, Tracking, Trucking' Sum Up Projects at Woods Hole Marine Biological Laboratory

TICKING, TRACKING, and trucking summed up the work described at the first annual Science Update at the Marine Biological Laboratory in Woods Hole, Mass. The update offered science writers a glimpse into the status of a handful of the many lines of research being conducted by the laboratory's scientists. For example, Felix Strumwasser, PhD, is studying the ticking of the circadian clock using a living model that can be studied in a dish: the eye of the sea slug Aplysia . John Hobbie, PhD, is directing the laboratory's role in an unprecedented international effort to track—and eventually predict—worldwide climate change. Shinya Inoue, PhD, and Bruce Schnapp, PhD, are using the most sophisticated techniques of video light microscopy and digital processing to look at, among many questions, how cells divide and molecules truck down the axon via microtubules. Strumwasser's research question is one that has intrigued neuroscientists for decades: how can the

STAT: The Laboratory's Role

STAT: The Laboratory's Role

The laboratory's role in environmental health emergency investigations.

An emergency environmental health investigation of a mass poisoning of unknown origin is a multidiscipline effort that requires the cooperation and close communication of epidemiologists, toxicologists, and chemists. The laboratory's role in this effort is important; special instruments, knowledge, and experience are needed. Our approach to such an investigation is discussed and past cases are used as illustrations. The role of the analytical chemist is presented, and the major resources needed for these investigations are described.

Laboratory Detection of Marijuana Use

To the Editor.— Schwartz and Hawks have provided an excellent discussion of the laboratory's role in the detection of marijuana use. 1 However, their statement that false-positive results of the homogeneous enzyme immunoassay technique (EMIT) and radioimmunoassay are rare when the tests are performed under optimal conditions requires clarification. Frederick et al 2 were unable to confirm by gas chromatography— mass spectrometry (GC-MS) the positive results obtained using the EMIT-d.a.u. (drugs of abuse in urine) on three of 42 urine specimens. Another study, using high-performance liquid chromatography and high-efficiency thin-layer chromatography, confirmed only 72% of the EMIT results that were positive at a lower cutoff of 20 ng/mL of 11-nor-Δ 9 -tetrahydrocannabinol-9-carboxylic acid (9-carboxy-THC). 3 The confirmation rate rose to 91% when 75 ng/mL was used as the lower detection limit. In a multicenter study, it was found that 2% of the results obtained from the EMIT single-test and EMIT-d.a.u.